Spine
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Randomized Controlled Trial Clinical Trial
Cost effectiveness of periradicular infiltration for sciatica: subgroup analysis of a randomized controlled trial.
A subgroup analysis of a prospective, randomized controlled trial was performed. ⋯ In addition to short-term effectiveness for contained herniations and lesions at L3-L4-L5, steroid treatment also prevented surgery for contained herniations. However, steroid was countereffective for extrusions. The results of the subgroup analyses call for a verification study.
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Axial load-dependent changes in the lumbar spine of supine healthy volunteers were examined using a compression device compatible with magnetic resonance imaging. ⋯ The axial force of 50% body weight in supine posture simulates the upright lumbar spine morphologically. No change in intervertebral angle occurred at L4-L5. However, disc height at L4-L5 decreased significantly during compression.
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Patients with low back pain, sciatica, and neurogenic claudication were observed during computed tomographic myelography or magnetic resonance imaging in psoas-relaxed position and axially compressed supine position of the lumbar spine. ⋯ According to the study results, axially loaded imaging adds frequent additional valuable information, as compared with conventional imaging methods, especially in patients with neurogenic claudication, but also in patients with sciatica if defined inclusion criteria are used.
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A case report of a multidisciplinary approach to a second reconstructive back surgery in a patient with von Willebrand's disease, flatback syndrome, and a history of heavy surgical bleeding is presented. ⋯ Using a careful multidisciplinary approach, excellent hemostasis can be achieved with minimal exposure to untreated allogeneic blood products during aggressive spinal surgery in a patient with a clinically significant congenital coagulopathy.
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A case series of seven children who had a thoracolumbar gibbus related to mucopolysaccharidosis treated with anterior instrumentation were reported retrospectively. ⋯ Anterior instrumented correction and fusion of the spine is effective in treating thoracolumbar kyphosis associated with mucopolysaccharidosis.